Organization
COUNTRY ROAD EMERGENCY PHYSICIANS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH H GATEWOOD, M.D. (OFFICER)
(469) 401-2386
Entity
Organization
Contact information
Practice address
3600 GATES BLVD, PORT ARTHUR, TX 77642-3858
(469) 401-2386
Mailing address
PO BOX 98953, LAS VEGAS, NV 89193-8692
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/16/2015
Last updated
12/14/2015
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